32670 Thoracoscopy, surgical; with removal of two lobes (bilobectomy)

Name of the Procedure:

Thoracoscopy, surgical; with removal of two lobes (bilobectomy)

Summary

A thoracoscopy involves using a small camera (thoracoscope) to view the chest cavity. A bilobectomy refers to the surgical removal of two lobes of the lung.

Purpose

This procedure is typically performed to treat lung cancer or severe infections affecting more than one lobe.

Indications

• Tumors or malignancies in two lobes of the lung
• Chronic infections that have not responded to other treatments
• Conditions like severe bronchiectasis requiring removal of more than one lobe

Preparation

• Fasting for 8 hours prior to the procedure.
• Adjustments to current medications, especially blood thinners.
• Preoperative diagnostic tests such as chest X-rays, CT scans, and pulmonary function tests.

Procedure Description

1. The patient is placed under general anesthesia.
2. Small incisions are made in the chest wall.
3. A thoracoscope is inserted to allow visualization.
4. Additional surgical instruments are inserted to remove the affected lobes.
5. The incisions are closed with sutures or staples, and chest tubes may be inserted to drain fluids.

Duration

The procedure usually takes between 3 to 5 hours.

Setting

Performed in a hospital operating room.

Personnel

• Thoracic surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a respiratory therapist

Risks and Complications

• Common risks: Bleeding, infection, pain
• Rare risks: Air leaks, pneumonia, reactions to anesthesia
• Management: Close monitoring post-surgery, use of antibiotics, pain management protocols

Benefits

• Removal of diseased lung tissue can lead to improved breathing function.
• Can potentially cure lung cancer if entirely removed.
• Symptom relief from chronic infections or other conditions.

Recovery

• Typical hospital stay of 5-7 days.
• Post-operative instructions include breathing exercises, avoiding strenuous activity, and attending follow-up appointments.
• Full recovery may take several weeks to months.

Alternatives

• Chemotherapy or radiation for cancer management.
• Less invasive procedures for smaller, localized issues.
• Each alternative has its own risks and benefits compared to thoracoscopy with bilobectomy.

Patient Experience

• During: The patient feels no pain during the procedure due to general anesthesia.
• After: Pain and discomfort managed with medications; possible chest tube placement which can be uncomfortable.

Pain management, deep breathing exercises, and gradual return to normal activities are vital for a smooth recovery.